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2017 ; 4
(3
): 344-348
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Cardiac arrest caused by rapidly increasing ascites in a patient with TAFRO
syndrome: a case report
#MMPMID29123888
Okumura M
; Ujiro A
; Otsuka Y
; Yamamoto H
; Wada S
; Iwata H
; Kan T
; Miyauchi S
; Hashimoto A
; Sato Y
; Fujita Y
; Fujiwara Y
; Shimaoka H
Acute Med Surg
2017[Jul]; 4
(3
): 344-348
PMID29123888
show ga
CASE: Thrombocytopenia, anasarca, fever, renal insufficiency, and organomegaly
(TAFRO) syndrome is a newly defined systemic inflammatory disorder with gradual
progression of symptoms. A 59-year-old man with fever and ascites of unknown
cause developed sudden-onset shock and respiratory failure in the general ward.
Cardiac arrest immediately followed. Although he was resuscitated, frequent
administration of adrenaline was required to maintain his blood pressure. His
circulation was most effectively stabilized by drainage of fluid from his
distended abdomen. The volume of discharged ascites reached 4,000 mL at that
time, and several liters continued to be discharged for >1 month. The diagnosis
of TAFRO syndrome was based on the clinical features and laboratory and
histological findings. OUTCOME: The ascites volume and concentrations of
inflammatory parameters decreased with treatment using several immunosuppressive
agents. CONCLUSION: The newly defined TAFRO syndrome may be life-threatening.
Patients should be monitored for progression to shock and cardiac arrest,
especially those with rapidly increasing ascites.